January 24, 2017
By Susan Cornwell
(Reuters) - U.S. Republican Senator Susan Collins called President Donald Trump's executive order against Obamacare "very confusing" on Monday, saying whatever actions the Trump administration takes, legislation will still be needed to replace the health insurance law.
"We really don't know yet what the impact (of the order) will be," Collins told reporters, adding that it will be difficult to assess the impact until there is a new Cabinet secretary in place in charge of health.
Collins, a moderate Republican from Maine, was speaking at a press conference to introduce her own legislation to replace former Democratic President Barack Obama's healthcare law.
Trump, who campaigned on a promise to dismantle Obamacare, signed his first executive order Friday within hours of taking office. It directs U.S. agencies to "waive, defer, grant exemptions from, or delay the implementation" of provisions of Obamacare deemed to impose fiscal burdens on states, companies or individuals.
But the order did not specify which parts of Obamacare would be affected, or over what timeline. Meanwhile, Republicans in Congress are working on legislation to repeal and replace the law.
Trump's nominee to head the U.S. Department of Health and Human Services, Georgia Representative Tom Price, has said there is no plan for "pulling the rug out" on millions of Americans' healthcare as a replacement is designed. Any changes are unlikely to affect the government-funded or subsidized insurance plans covering more than 20 million people in 2017.
Collins' replacement proposal, which she offered together with Republican Senator Bill Cassidy of Louisiana, would allow states to stay in Obamacare if they like. They could also choose an alternative plan that would be developed using the funding they would otherwise get from Washington for subsidizing Obamacare coverage and the expansion of the Medicaid health insurance program for the poor.
"We need legislation," Collins said. "There are some improvements that can be made through the executive order, and through the regulatory process, but that by no means takes away the need for comprehensive legislation."
Cassidy rejected the idea that letting states keep Obamacare if they like amounted to a retreat from Republican vows to repeal the 2010 law.
"What we're doing is moving the locus for repeal to state governments," he said. Republicans believe such decisions should be made at the state level, Cassidy said, but added that this approach could also help attract Democratic votes that will be needed for a replacement plan.
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